Specific Serological Tests Can Now Reliably Detect All Cases of Celiac Disease

Scott Adams

In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I created The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

*IMMCO Diagnostics, Inc., Buffalo, New York 14228; Departments of Microbiology
and Dermatology, State University of New York at Buffalo, Buffalo, New
York 14214; and Department of Dermatology, Warsaw School of Medicine,
Warsaw, Poland; ** Department of Gastroenterology and Pediatrics, Selesian
School of Medicine, Warsaw, Poland

Clinical Diagnostic Immunology 9:1295-1300, 2002.

Celiac.com 12/31/2002 - Background: Immunoglobulin A (IgA) deficiency is 10-15 times more common
in patients with Celiac Disease (CD) than in normal subjects. Serological
tests have become the preferred methods of detecting both symptomatic
and asymptomatic patients with CD. However, commercially available serological
methods are limited in that they detect only the IgA isotype of antibodies
(with the exception of IgG gliadin assays); hence, IgA deficient celiac disease patients
may yield false negative serology.

Results: Twenty five specimens with IgA deficiency were examined. Fifteen
were celiac disease cases and ten were non-CD cases. All fifteen IgA deficient celiac disease
cases were positive for endomysium antibodies of the IgG isotype and for
IgG gliadin antibodies. All but one of the IgA deficient celiac disease cases were
also positive for IgG tissue transglutaminase antibodies. None of the
non-CD IgA deficient cases were positive for any of the antibody markers.
All the specimens examined were also negative for IgA specific antibodies
to endomysium, gliadin, and tissue transglutaminase.

Conclusions: IgG specific antibody tests for endomysium, gliadin and
tissue transglutaminase are useful for the identification of IgA deficient
celiac disease patients. IgG antibody tests along with tests routinely being used
in clinical laboratories can reliably detect all active celiac disease patients. In
addition, the levels of these CD-specific IgG antibodies could be used
to monitor patient dietary compliance.